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Comparison of microcoils and polyvinyl alcohol particles in selective microcatheter angioembolization of non variceal acute gastrointestinal hemorrhage.

- Pak J Med Sci (2015 Jul-Aug)

Bottom Line: Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates.Technical success was achieved in all cases (100%).Clinical success rate was higher in microcoils group (92%) than PVA particles group (75%) with statistically significant P value (p=0.048).

View Article: PubMed Central - PubMed

Affiliation: Dr. Tanveer-Ul-Haq, FRCR, Department of Radiology, Aga Khan University Hospital, Stadium Road, 74800 Karachi, Pakistan.

ABSTRACT

Objectives: To compare the efficacy of polyvinyl alcohol (PVA) particles with microcoils in angiembolisation of non variceal acute gastrointestinal haemorrhage.

Methods: This is a retrospective cross-sectional study of patients who underwent transcatheter angioembolization from January, 1995 to December, 2013 at Aga Khan University Hospital, Karachi. Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates. Chi (χ(2)) square and Fisher's exact tests were applied and a P-value of less than 0.05 was considered statistically significant.

Results: Fifty seven patients underwent angioembolization. Microcoil and PVA particles embolization was performed in 63% (36/57) and 35% (20/57) cases respectively. Technical success was achieved in all cases (100%). Clinical success rate was higher in microcoils group (92%) than PVA particles group (75%) with statistically significant P value (p=0.048). Ischemic complication was seen in one case (3%) in the microcoil group, while no such complications were seen in the PVA particles group.

Conclusion: In angioembolization of non variceal acute gastrointestinal haemorrhage microcoils are better than Polyvinyl alcohol particles with higher clinical success and lower re-bleed rates.

No MeSH data available.


Related in: MedlinePlus

Micro coil angioembolisation.Digital subtraction angiography image showing catheter tip in distal branch of left colic artery showing active bleed marked by long white arrow. Subsequently angioembolisation performed by placement of platinum microcoil and complete cessation of bleeding achieved.
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Figure 1: Micro coil angioembolisation.Digital subtraction angiography image showing catheter tip in distal branch of left colic artery showing active bleed marked by long white arrow. Subsequently angioembolisation performed by placement of platinum microcoil and complete cessation of bleeding achieved.

Mentions: Diagnostic angiography was performed in all patients by standard transfemoral catheterization technique using a 5-French vascular access sheath inserted under ultrasound and fluoroscopic guidance and a 4-French Cobra or Simmon catheter (Cordis, Johnson and Johnson, FL, USA) over a 0.035” Terumo Radifocus guide wire (Terumo medical corporation, NJ, USA). First, selective angiography of celiac, superior mesenteric and inferior mesenteric arteries was done depending on the findings of endoscopy and/or red blood cell (RBC)-tagged scintigraphy. Once the site of bleeding was identified, superselective angiography was performed using a 2.9-French microcatheter (Progreat, Terumo, Japan), which was inserted co-axially through the already placed 4-Fr catheter. Extravasation of contrast media and/or the presence of arterial pseudo-aneurysm indicated bleeding. Microcatheter was then manipulated to reach the vasa recta and angioembolization was performed by using either microcoils (size range: 0.015”-0.018”; Balt, Extrusion, France) [Fig.1] or PVA particles (size range: 250-350 μm; Boston scientific, Natick, MA, USA) [Fig.2] or both.


Comparison of microcoils and polyvinyl alcohol particles in selective microcatheter angioembolization of non variceal acute gastrointestinal hemorrhage.

- Pak J Med Sci (2015 Jul-Aug)

Micro coil angioembolisation.Digital subtraction angiography image showing catheter tip in distal branch of left colic artery showing active bleed marked by long white arrow. Subsequently angioembolisation performed by placement of platinum microcoil and complete cessation of bleeding achieved.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590394&req=5

Figure 1: Micro coil angioembolisation.Digital subtraction angiography image showing catheter tip in distal branch of left colic artery showing active bleed marked by long white arrow. Subsequently angioembolisation performed by placement of platinum microcoil and complete cessation of bleeding achieved.
Mentions: Diagnostic angiography was performed in all patients by standard transfemoral catheterization technique using a 5-French vascular access sheath inserted under ultrasound and fluoroscopic guidance and a 4-French Cobra or Simmon catheter (Cordis, Johnson and Johnson, FL, USA) over a 0.035” Terumo Radifocus guide wire (Terumo medical corporation, NJ, USA). First, selective angiography of celiac, superior mesenteric and inferior mesenteric arteries was done depending on the findings of endoscopy and/or red blood cell (RBC)-tagged scintigraphy. Once the site of bleeding was identified, superselective angiography was performed using a 2.9-French microcatheter (Progreat, Terumo, Japan), which was inserted co-axially through the already placed 4-Fr catheter. Extravasation of contrast media and/or the presence of arterial pseudo-aneurysm indicated bleeding. Microcatheter was then manipulated to reach the vasa recta and angioembolization was performed by using either microcoils (size range: 0.015”-0.018”; Balt, Extrusion, France) [Fig.1] or PVA particles (size range: 250-350 μm; Boston scientific, Natick, MA, USA) [Fig.2] or both.

Bottom Line: Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates.Technical success was achieved in all cases (100%).Clinical success rate was higher in microcoils group (92%) than PVA particles group (75%) with statistically significant P value (p=0.048).

View Article: PubMed Central - PubMed

Affiliation: Dr. Tanveer-Ul-Haq, FRCR, Department of Radiology, Aga Khan University Hospital, Stadium Road, 74800 Karachi, Pakistan.

ABSTRACT

Objectives: To compare the efficacy of polyvinyl alcohol (PVA) particles with microcoils in angiembolisation of non variceal acute gastrointestinal haemorrhage.

Methods: This is a retrospective cross-sectional study of patients who underwent transcatheter angioembolization from January, 1995 to December, 2013 at Aga Khan University Hospital, Karachi. Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates. Chi (χ(2)) square and Fisher's exact tests were applied and a P-value of less than 0.05 was considered statistically significant.

Results: Fifty seven patients underwent angioembolization. Microcoil and PVA particles embolization was performed in 63% (36/57) and 35% (20/57) cases respectively. Technical success was achieved in all cases (100%). Clinical success rate was higher in microcoils group (92%) than PVA particles group (75%) with statistically significant P value (p=0.048). Ischemic complication was seen in one case (3%) in the microcoil group, while no such complications were seen in the PVA particles group.

Conclusion: In angioembolization of non variceal acute gastrointestinal haemorrhage microcoils are better than Polyvinyl alcohol particles with higher clinical success and lower re-bleed rates.

No MeSH data available.


Related in: MedlinePlus